高龄大肠癌外科治疗158例分析

The analysis of surgical treatment of the elderly patients for colorectal carcinoma with report of 158 cases.Gao Zhangyuan,Jin Guoxiang,Tu Yue,et al.Depa

目的探讨高龄大肠癌围手术期处理的有关问题。方法回顾性分析了１９９１年１０月至１９９７年５月１５８例７０岁以上大肠癌病人的外科处理。结果根治性切除１１３例，切除率７１５％，姑息性切除１５例，Ｈａｒｔｍａｎｎ术９例，结肠造口１８例，短路３例。术后并发症４３例，围手术期死亡１２例，病死率７６％。结论对高龄大肠癌病人除加强围手术期营养支持外，充分的术前准备，适当的手术时机与手术方式的选择，完善的麻醉及心肺功能监测，精细简洁的手术操作，是减少并发症，提高根治性切除的有效方法。

Objective To explore the pertinent problems in the perioperative period management of the elderly patients suffered from colorectal carcinoma. Methods From Oct 1991 to May 1997,158 cases of more than 70 years old during were analyzed retrospectively. Results 113 cases underwent radical resection(resection rate 71\^5%).15 cases received palliative resection and 9 cases Hartmanns.18 cases colostomy,3 cases bypass.With complications in 43 cases and 12 deaths(mortality 7\^6%). Conclusion Besides the nutrition support in perioperative period.We hold that the effective way to eliminate the morbidity and improve the curative resection rate lies in the fully preoperative preparation.The appropriate choice of operation time and operation procedure.The perfect anesthesia and cardiopulmonary mornitoring and the piecise and concise techniques in operation.